Effectiveness of the AUDIT-C as a Screening Test for Alcohol Misuse in Three Race/Ethnic Group
J Gen Intern Med, Online first 18 April 2008



The Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) is a brief validated screen for risky drinking and alcohol abuse and dependence (alcohol misuse). However, the AUDIT-C was validated in predominantly White populations, and its performance in different racial/ethnic groups is unclear.

Race/ethnicity was self-reported. Areas under the receiver operating curve (AuROCs) evaluated overall AUDIT-C performance in the 3 racial/ethnic groups compared to diagnostic interviews for alcohol misuse. AUDIT-C sensitivities and specificities at recommended screening thresholds were compared across racial/ethnic groups. AuROCs were greater than 0.85 in all 3 groups, with no significant differences across racial/ ethnic groups in men (P=.43) or women (P=.12). At previously recommended cut points, there were statistically significant differences by race in AUDIT-C sensitivities but not specificities. In women, the sensitivity was higher in Hispanic (85%) than in African-American (67%; P=.03) or White (70%; P=.04) women. In men, the sensitivity was higher inWhite (95%) than in African-Americanmen (76%; P=.01), with no significant difference from Hispanic men (85%; P=.11).

The overall performance of the AUDITC was excellent in all 3 racial/ethnic groups as reflected by high AuROCs. At recommended cut points, there weresignificant differences in the AUDIT-C’s sensitivity but not in specificity across the 3 racial/ethnic groups.

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